Overview
This research project compares the effectiveness of different surgical techniques for lengthening the gastrocnemius-soleus system in patients with equinus deformity. The study will compare 2 techniques: gastrocnemius tendon recession (Strayer) and plantaris resection. Increased ankle range of motion, complications, operative time, recovery time, pain scales and function will be measured. The results will help determine which technique is most effective and safe for correcting equinus deformity.
Description
Equinus deformity is a common deformity caused by contracture of the triceps suralis, especially the gastrocnemius. This causes limitation of ankle dorsiflexion, pain and gait incompetence. Treatment includes surgical lengthening techniques such as gastrocnemius tendon recession (Strayer) or isolated plantar tendon transection.
The minimally invasive Strayer technique is effective but carries morbidity. Ultrasound-guided plantar tendon transection is a new minimally invasive technique but its effectiveness has not been well established.
The aim of this study is to compare the efficacy and safety of the Strayer technique versus isolated plantar tendon transection in the surgical treatment of the equinus deformity. The results will help determine the best surgical option for increasing ankle range of motion in these patients.
To compare the effectiveness of the Strayer technique (gastrocnemius tendon recession) versus plantar tendon transection in patients with equinus deformity
Patients will be divided into two groups:
Group 1: Patients with isolated gastrocnemius contracture undergoing Strayer technique. This consists of ultrasound-guided recession of the gastrocnemius tendon distally.
Group 2: Patients with mild contracture undergoing ultrasound-guided plantar tendon transection of the medial aspect of the gastrocnemius.
The main variables will be the increase in the range of mobility of the ankle, measured with a goniometer before and after surgery. Pain will also be evaluated with visual analogue scale, function with American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score scale, complications and surgical time.
Descriptive statistics, paired Student's t-test for before/after and Student's t-test for independent samples between groups will be used.
The objective is to determine which technique allows a greater increase in ankle range of motion in patients with equinus deformity in a safe and effective manner. The results will help to establish the best surgical option for patients with gastrocnemius contracture.
The study complies with ethical requirements and has the approval of the ethics committee of the Catholic University of Valencia.
Eligibility
Inclusion Criteria:
- Clinical and radiological diagnosis of clubfoot.
- Limitation of passive dorsiflexion of the ankle (<10°).
- Associated pain and functional limitation
- Absence of previous ankle/foot surgeries
Exclusion criteria:
- Neurologic or congenital disease.
- Advanced ankle joint osteoarthritis
- Peripheral vascular insufficiency
- Uncontrolled diabetes mellitus
- Severe hepatic or renal disease
- Coagulopathies or anticoagulant therapy